Odontogenic Orbital Cellulitis due to an Oroantral Fistula following Dental Extraction: A Case Report
Bibliographic record
Abstract
Introduction: Orbital cellulitis is a serious infection involving the soft tissues of the orbit. Odontogenic orbital cellulitis (OOC) is an important subtype and typically results from the contiguous spread of a dental infection. One uncommon route for this spread is the development of an oroantral fistula (OAF), a communication between the oral cavity and maxillary sinus which typically arises after extraction of a maxillary molar. Case Presentation: A 47-year-old female presented to the emergency department with a 1-day history of right-sided periorbital edema and pain on extraocular movements. She had a history of a right maxillary dental infection which required tooth extraction 2 months prior to presentation. Her ocular exam revealed right periorbital edema and erythema that extended down to the midface with mild tenderness to palpation. Computed tomography scan showed pre-septal cellulitis, post-septal fat stranding, and a right-sided OAF. The patient had a complete resolution of infection and spontaneous closure of the OAF after 1 month of meropenem 1 g IV daily. Conclusion: In conclusion, this case highlights a rare presentation of OOC due to an OAF occurring months after dental extraction. Immediate imaging due to atypical history, including lack of dental pain, allowed for prompt identification of the OAF and subsequent use of appropriate broad-spectrum antibiotics resulting in a favorable outcome compared to previously published cases. It is critical to recognize odontogenic infections as treatment differs from other etiologies of orbital cellulitis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".